Biomedical subjects

T A Berg

Publications and source records attributed to T A Berg.

5 recordsLinked to original sources

PubMed2001

Sutureless mechanical anastomosis of a saphenous vein graft to a coronary artery with a new connector device.

Construction of vascular anastomoses by manual suturing is a highly skilled and time-consuming procedure. The St Jude Medical Anastomotic Technology Group has developed a sutureless mechanical anastomosis device, which, when tested in animals, produced anastomoses in less than 3 min and with little training. Here we present the results of the first clinical saphenous-vein to coronary-artery anastomosis by means of this device.

Coronary Artery Bypass↗

PubMed2001

Minimizing aortic manipulation during OPCAB using the symmetry aortic connector system for proximal vein graft anastomoses.

BACKGROUND: Since minimal invasive techniques have become increasingly common in coronary artery bypass grafting (CABG), there has been renewed interest in facilitated mechanical anastomoses devices that might have the potential of replacing the standard suturing techniques in vascular anastomoses. We report our initial experience with the successful creation of mechanical proximal vein graft anastomoses in off-pump coronary artery bypass operations. METHODS: From August to December 2000, we investigated the first 20 consecutive patients who underwent CABG on the beating heart without extracorporeal circulation and who received at least one mechanical proximal vein graft anastomosis with the St. Jude Medical Symmetry aortic connector system without side-clamping of the aorta. We evaluated the different components of the system, the feasibility of such anastomoses, and the intraoperative flow measurements of the grafts using transit time methods. RESULTS: A total of 32 proximal vein graft anastomoses were performed with the aortic connector system. Hemostasis was instantaneous in all cases except one, in which the connector was removed and the anastomosis was hand-sewn without complications. All other vein grafts were patent at the end of the procedure; intraoperative flow measurements were 39 +/- 25 mL/min for single vein grafts (n = 20) and 69 +/- 25 mL/min for sequential grafts (n = 11). CONCLUSIONS: The St. Jude Medical Symmetry aortic connector system is a user-friendly, effective, quick, and reliable device for sutureless proximal vein graft anastomosis in CABG. This system allows the construction of uniform and geometrically perfect anastomoses and does not require aortic side-biting. This technology is attractive for all CABG procedures because aortic manipulation is reduced. In off-pump surgical procedures the connector system allows aortic manipulation to be minimized, potentially reducing embolization from aortic wall debris.

Adult↗

PubMed1989

Does fine-needle aspiration biopsy really spare patients thyroidectomy?

Fine-needle aspiration (FNA) biopsy is widely used in the evaluation of nodular thyroid disease. From January 1979 to May 1983, 100 patients underwent FNA biopsy at Wake Forest University Medical Center for evaluation of nodular thyroid disease. Forty-six underwent immediate thyroidectomy based upon clinical and cytologic criteria. Fifty-three patients identified as having benign atypical or normal cells initially were managed nonoperatively. An additional patient with Hürthle cell neoplasm diagnosed by cytologic evaluation refused surgery and is included in the group treated nonsurgically. This report concentrates on the characteristics and subsequent course of these 54 patients. Emphasis was placed on whether surgery was actually avoided or merely delayed by the results of FNA biopsy. Follow-up evaluation ranged from 16 to 92 months (mean, 57 months). Fifty-two (96%) patients had not been operated upon for thyroid disease during the follow-up period, and in none of the 52 had there developed new indications for surgery. The two (4%) patients who had undergone thyroidectomy proved to have benign disease. The authors conclude that with adequate clinical follow-up, FNA biopsy can accurately and appropriately guide the nonoperative management of nodular thyroid disease, and that the technique does spare patients the cost and risk of thyroidectomy, both initially and during subsequent follow-up evaluation.

Adenoma↗

PubMed1979

Nursing the newborn.

Factors affecting successful breast-feeding that have been discussed include good prenatal and postnatal patient education, supportive routines in the hospital, and prevention and/or treatment of common early problems. Suggestions have been made of ways in which the breast-feeding experience can be enhanced. As these measures become more widespread, along with knowledge of the benefits and advantages of human milk and breast-feeding, we should be able to continue to reverse the trend away from breastfeeding.

Breast↗

PubMed1977

Heavy metal-nucleotide interactions. IX. Raman difference spectroscopic studies on the binding of CH3Hg(II) to 1-methylthymine, thymidine-5'-monophosphate, DNA models and native DNA.

Raman spectra have been obtained for dTMP and its complex with CH3Hg (II) in aqueous solution as a function of pH. Difference spectroscopy is employed to increase the sensitivity of the Raman technique. The binding reaction is essentially quantitative from pH 3 to 9, and the value of the equilibrium constant for CH3HgOH2+ + dThd in equilibrium CH3Hg(dThdH--1) + H30+ is estimated from intensity measurements to be 0.6 in reasonable agreement with an earlier value based upon uv spectrophotometric data. Binding is to N(3) with substitution of CH3Hg+ for the proton. A similar reaction occurs with 1-MeThy. Raman spectra for aqueous and crystalline 1-MeThy and for the complex CH3Hg(1-MeThyH--1) are reported. The spectrum of crystalline Hg(1-MeThyH--1)2, for which the crystal structure is known, also was obtained for comparison. Raman difference spectroscopy was used to confirm that CH3Hg (II) binds to N(3) of dTMP and N(1) of GMP at r = 0.2 (MeHg+: phosphate) ratios with mixtures of GMP + CMP + AMP + dTMP. In contrast, native calf thymus DNA does not appear to bind CH3Hg(II) at these sites at r = 0.15, although no significant amount of free CH3HgOH is present. With r = 0.3, extensive binding occurs both to the Thy and Gua bases. Raman difference spectroscopy is a valuable technique for studying the binding of ions and molecules to polynucleotides in moderately dilute aqueous solution.

Adenosine Monophosphate↗